Home Health & Hospice Week

Use of in-network hospices is growing.

Hospices hoping that early problems with the Medicare Advantage Value-Based Insurance Design model’s hospice carve-in would scuttle the program will be disappointed with Medicare’s evaluation of the program’s second year.

Why? “The Hospice Benefit component was not associated with changes in hospice enrollment or care patterns in 2021,” notes the Centers for Medicare & Medicaid Services in its report. “However, participation was associated with a small, statistically significant increase in care quality (about 3 percent in 2021),” based on Consumer Assessment of Healthcare Providers and Systems (CAHPS) data.

That’s probably not great for hospices. “Hospices and new insurers reported substantial implementation challenges,” CMS notes. “But insurers with more than one year of experience with VBID reported fewer challenges, suggesting that implementation is becoming easier over time.” That may not be true for hospices, however.

And while “in 2022, beneficiaries could elect to receive care from out-of-network (OON) hospices with no additional cost sharing,” the percentage of benes using in-network providers rose from 37 percent in 2021 to 52 percent in 2022. That could make accepting subpar reimbursement rates and other disadvantages from MA plans a necessity for some hospices.

The 169-page report is at www.cms.gov/priorities/innovation/data-and-reports/2023/vbid-2nd-eval-report.